背景：有資料顯示乙型肝炎病毒（HBV）感染可增加患胰腺癌風險（PAC），但對于兩者是否有直接關系仍有爭議。另外，至目前為止還不知道HBV感染階段是否增加PAC感染風險的。因此，我們進行了一項分析，更深入探討HBV感染與PAC之間的關聯(lián)。

    方法：我們分析和檢索了2012年8月前的PubMed和其他相關數據庫，在綜合分析匯總相對危險（RR），95％可信區(qū)間（CI），采用隨機效應和固定效應模型，并采用Cochrane協(xié)作網的應用Revman 5.1。

    結果：9個研究，其中包括6病例對照研究和隊列研究均符合標準。分析表明，PAC風險與乙肝病毒感染呈正相關，“而從來沒有接觸到乙肝病毒的人群，RR為1.39（95％CI 1.22-1.59，P <0.00001），慢性乙肝病毒攜帶者中為1.41（ 95％CI 1.06-1.87，P = 0.02），在HBV感染活躍期為3.83（95％CI 1.76-8.36，P = 0.0007）。使用分層分析，我們也發(fā)現(xiàn)，吸煙，飲酒，糖尿病也能增加PAC的風險。

    結論：這一分析結果強烈支持HBV感染與PAC密切相關，即乙型肝炎病毒（HBV）感染可增加患胰腺癌風險（PAC）。

   BACKGROUND:Hepatitis B virus (HBV) infection is reported to be associated with an increased risk of pancreatic cancer (PaC), but it remains controversial whether this is a causal relationship. In addition, it is unclear whether the status of HBV infection also affects PaC risk. Therefore, we conducted a meta-analysis to more closely examine the association between HBV infection and PaC.

    METHOD:The studies included in the meta-analysis were identified and retrieved from PubMed and several other databases. The literature search was conducted up until August 2012. We adopted the Cochrane Collaboration's RevMan 5.1 in a combined analysis of pooled relative risk (RR) with their corresponding 95 % confidence intervals (CIs) using a random-effects and a fixed-effects model.

    RESULTS:Nine studies including 6 case-control and 3 cohort studies met eligibility criteria. The meta-analysis showed that the PaC risk was positively correlated with HBV infection when comparing with 'never exposed to HBV' subgroup, the pooled RR was 1.39 (95 % CI 1.22-1.59, p < 0.00001) in chronic HBV carriers, 1.41 (95 % CI 1.06-1.87, p = 0.02) in past exposure to HBV, and 3.83 (95 % CI 1.76-8.36, p = 0.0007) in active HBV infection. Using a stratified analysis, we also found that the risk of PaC was independent of smoking, alcohol drinking, and diabetes.

    CONCLUSION:Findings from this meta-analysis strongly support that HBV infection is associated with an increased risk of PaC.

    查看原文：http://www.ncbi.nlm.nih.gov/pubmed/23306552